Vascular Pathology Practice Questions

Q: Strawberry gingivitis is a characteristic finding in which condition?

Wegener's Granulomatosis. **Strawberry Gingivitis** is a pathognomonic clinical sign of **Wegener’s Granulomatosis** (now known as Granulomatosis with Polyangiitis or GPA). It is characterized by reddish-purple, granular, and friable swelling of the gingiva with petechial hemorrhages, resembling the surface of a strawberry. This occurs due to necrotizing granulomatous inflammation and underlying small-vessel vasculitis. [1] **Why the other options are incorrect:** * **Scorbutic Gingivitis (Vitamin C deficiency):** Presents with swollen, spongy, and bleeding gums, but lacks the specific granular "strawberry" appearance. It is associated with defective collagen synthesis. * **Plasma Cell Gingivitis:** An allergic/hypersensitivity reaction (often to toothpaste or chewing gum) showing diffuse, bright red involvement of the free and attached gingiva, characterized histologically by dense plasma cell infiltration. * **Leukemic Gingivitis:** Common in Acute Myeloid Leukemia (especially AML-M4 and M5). It presents as diffuse gingival enlargement due to direct infiltration by leukemic cells, rather than the specific granular vasculitic pattern of GPA. **NEET-PG High-Yield Pearls for GPA:** * **Triad:** Necrotizing granulomas of the respiratory tract (upper and lower), necrotizing vasculitis of small-to-medium vessels, and renal disease (crescentic glomerulonephritis). [1] * **Serology:** Highly associated with **c-ANCA** (anti-PR3 antibodies). [1] * **Classic Presentation:** Saddle-nose deformity, chronic sinusitis, hemoptysis (lung nodules/cavities), and hematuria. * **Treatment:** Cyclophosphamide and Corticosteroids. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of Infancy and Childhood, pp. 518-520.

Question 1

Which of the following vasculitides is ANCA negative?

Accepted Answer

Polyarteritis nodosa

Answer

Microscopic polyangiitis

Answer

Churg-Strauss syndrome

Answer

Granulomatosis with polyangiitis

Question 2

What is the most common site of lymphangiosarcoma?

Accepted Answer

Post-mastectomy edema of the arm

Answer

Liver

Answer

Spleen

Answer

Retroperitoneum

Question 3

What is the most common site of origin of thrombotic pulmonary emboli?

Accepted Answer

Deep leg veins

Answer

Lumen of left ventricle

Answer

Lumen of right ventricle

Answer

Mesenteric veins

Question 4

Which is the most common cause for dissecting aneurysm of the thoracic aorta?

Accepted Answer

Medial degeneration

Answer

Atherosclerosis

Answer

Syphilis

Answer

Trauma

Question 5

All of the following cause necrotizing inflammation in vasculitis EXCEPT?

Accepted Answer

Kawasaki disease

Answer

Polyarteritis nodosa

Answer

Wegener's granulomatosis

Answer

Microscopic polyangiitis

Question 6

Which of the following is NOT a characteristic of atheroma resulting in angina?

Accepted Answer

Absence of macrophages

Answer

Thin fibrous cap

Answer

Thick fibrous cap

Answer

Absence of smooth muscle cells

Question 7

Which of the following is NOT a granulomatous vasculitis?

Accepted Answer

Buerger's disease

Answer

Churg-Strauss disease

Answer

Takayasu arteritis

Answer

Wegener's granulomatosis

Question 8

A patient with cystic medial necrosis and necrotizing arteritis is suffering from which condition?

Accepted Answer

Aortitis

Answer

Kawasaki disease

Answer

Temporal arteritis

Answer

Malignant hypertension

Question 9

Strawberry gingivitis is a characteristic finding in which condition?

Accepted Answer

Wegener's Granulomatosis

Answer

Scorbutic Gingivitis

Answer

Plasma Cell Gingivitis

Answer

Leukemic Gingivitis

Question 10

All endothelial cells are involved in the production of thrombomodulin EXCEPT those found in:

Accepted Answer

Cerebral microcirculation

Answer

Hepatic circulation

Answer

Cutaneous circulation

Answer

Renal circulation

Vascular Pathology — MCQs

Vascular Pathology — MCQs

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